Title 12, HUMAN SERVICES

Sec. 6. (a) Beginning on the date on which a notice of lien is recorded in the office of the county recorder under section 5 of this chapter, the notice of lien: (1) constitutes due notice of a lien against the Medicaid recipient's real property for any amount then recoverable an…

Sec. 7. The office may bring proceedings in foreclosure on a lien arising under this chapter: (1) during the lifetime of the Medicaid recipient if the Medicaid recipient or a person acting on behalf of the Medicaid recipient sells the property; or (2) upon the death of the Medica…

Sec. 8. The office may not enforce a lien against a Medicaid recipient's home under this chapter as long as any of the following individuals reside in the home: (1) The recipient's child of any age if the child: (A) resided in the home for at least twenty-four (24) months before …

Sec. 9. (a) The office shall release a lien imposed under this chapter within ten (10) business days after the division of family resources receives notice that the Medicaid recipient: (1) is no longer living in the medical institution; and (2) has returned home to live. (b) The …

Sec. 1. Notwithstanding any other provision of this article, the rate of payment for the services and materials provided by physicians and transportation providers under the hospital care for the indigent program is the same rate as payment for the same type of services and mater…

Sec. 1. An individual who believes the individual is a drug abuser may request the division or a facility approved by the division to provide the individual with treatment. As added by P.L.187-2015, SEC.18.

Sec. 2. Upon receipt of a request, the division or facility may require an examination of the individual to determine if: (1) the individual is a drug abuser; and (2) the individual should be admitted to an existing treatment facility or program. As added by P.L.187-2015, SEC.18.…

Sec. 3. The examination shall be conducted within a reasonable time of the receipt of a request. As added by P.L.187-2015, SEC.18.

Sec. 4. The decision of the facility whether to offer treatment to an individual and whether to discontinue treatment to an individual is final and not subject to appeal. As added by P.L.187-2015, SEC.18.

Sec. 1. The division shall, with the advice of the division's medical staff, the division of mental health and addiction, the division of disability, aging, and rehabilitative services, and other individuals selected by the director of the division, adopt rules under IC 4-22-2 to…

Sec. 2. To the extent possible, rules adopted under section 1 of this chapter must be consistent with IC 12-15-21-2 and IC 12-15-21-3. As added by P.L.120-2002, SEC.26.

Sec. 3. The rules adopted under section 1 of this chapter must include rules that will deny payment for services provided to a patient after the patient is medically stable and can safely be discharged. As added by P.L.120-2002, SEC.26.

Sec. 4. (a) The division shall adopt rules under IC 4-22-2 necessary to establish a statewide collection system of data concerning the hospital care for the indigent program. (b) The following data must be collected: (1) Patient demographics. (2) Types of services provided by hos…

Sec. 5. The division may adopt rules under IC 4-22-2 that are in addition to and consistent with the rules required to be adopted under IC 12-16-6.5 governing appeals brought under the hospital care for the indigent program to the division. As added by P.L.120-2002, SEC.26.

Sec. 1. (a) Except as provided in subsection (b), an individual who is: (1) an alcoholic; (2) incapacitated by alcohol; or (3) a drug abuser; may be involuntarily committed to the care of the division under IC 12-26. (b) A drug abuser who is charged with or convicted of an offens…

Sec. 2. (a) Acceptance of treatment for drug abuse under the supervision of the division may be made a condition of parole under IC 11-13-3-4. Failure to comply with treatment may be treated as a violation of parole. (b) The division shall establish the conditions under which a p…

Sec. 1. As used in this chapter, "institution" means any of the following: (1) A health facility licensed under IC 16-28 as a comprehensive care facility. (2) An intermediate care facility for individuals with intellectual disabilities. As added by P.L.274-2003, SEC.5. Amended by…

Sec. 2. (a) This chapter is subject to funding available to the office of the secretary of family and social services. (b) The secretary and the director of the state budget agency are responsible for ensuring that the cost of the services provided under this chapter does not exc…

Sec. 3. The office of the secretary of family and social services shall establish a comprehensive program of home and community based long term care services to provide eligible individuals with care that is not more costly than services provided to similarly situated individuals…

Sec. 4. An individual who has resided in the state for at least ninety (90) days shall be eligible for the home and community based long term care services program if the individual: (1) participates in, or has been determined to be eligible for, the community and home options to…

Sec. 4.5. (a) As used in this section, "functional eligibility assessment" means a review of an individual's functional impairment level to determine whether an individual meets the eligibility requirements for the state's Medicaid aged and disabled waiver. (b) As used in this se…

Sec. 5. The state shall provide access to the following long term care services that are appropriate and needed for an individual who is eligible for these services under this chapter: (1) Any home and community based service that is available through: (A) the community and home …

Sec. 7. When possible, the office of the secretary of family and social services shall make use of volunteers and volunteer groups, including faith based groups, when executing its duties under this chapter. As added by P.L.274-2003, SEC.5.

Sec. 9. If the division performs inspections for compliance with state and federal home and community based services requirements, the division shall issue written findings to the person inspected not later than thirty (30) calendar days after the date of inspection. As added by …

Sec. 0.5. This chapter does not apply to a managed care organization that, on or before July 1, 2000, did not directly contract with a hospital (as defined in section 1 of this chapter) for the provision of services under the office's managed care program. As added by P.L.141-200…

Sec. 1. As used in this chapter, "hospital" refers to an acute care hospital provider that: (1) is licensed under IC 16-21; (2) qualifies as a disproportionate share hospital under IC 12-15-16; and (3) is the sole disproportionate share hospital in a city located in a county havi…

Sec. 10. A hospital and the managed care organization of the office shall use the arbitration procedure in section 8 of this chapter for the resolution of all disputed claims that have accrued as of March 17, 2000. As added by P.L.220-2011, SEC.265. Amended by P.L.152-2017, SEC.1…

Sec. 2. The office's managed care organization shall regard a hospital as a contracted provider in the office's managed care program, which provides a capitated prepayment managed care system, for the provision of medical services to each individual who: (1) is eligible to receiv…

Sec. 6. A claim for reimbursement for services shall be treated as a disputed claim under this chapter if: (1) it is submitted within one hundred twenty (120) days after the date that services are rendered; (2) it is denied by the managed care organization; (3) the hospital submi…

Sec. 7. The office's managed care organization must conclude an appeal under section 6(4) of this chapter and notify the hospital of its decision not more than thirty-five (35) days after the managed care organization receives a notice from the hospital disputing the managed care…

Sec. 8. (a) A contract entered into by a hospital with the office's managed care organization for the provision of services under the office's managed care program must include a dispute resolution procedure for all disputed claims. Unless agreed to in writing by the hospital and…

Sec. 9. The arbitration process described in section 8 of this chapter shall also be followed for resolution of disputed claims between a hospital and the office's managed care organization, if the hospital is not a contracted provider in the office's managed health care program.…

Sec. 1. As used in this chapter, "area agency" means an area agency on aging designated by the bureau of better aging under IC 12-10-1-4. As added by P.L.167-2025, SEC.8. Amended by P.L.122-2026, SEC.59.

Sec. 2. As used in this chapter, "covered population" means all Medicaid recipients who meet the criteria set forth in section 4 of this chapter. As added by P.L.167-2025, SEC.8.

Sec. 3. As used in this chapter, "office" includes the following: (1) The office of the secretary of family and social services. (2) A managed care organization that has contracted with the office of Medicaid policy and planning under this article. (3) A person that has contracte…

Sec. 4. An individual is a member of the covered population if the individual: (1) is eligible to participate in the federal Medicare program (42 U.S.C. 1395 et seq.) and receives nursing facility services; or (2) is: (A) at least sixty (60) years of age; (B) blind, aged, or disa…

Sec. 5. The office may contract with an area agency to: (1) provide; and (2) receive reimbursement for; a level of care assessment for the risk based managed care program for the covered population through an area agency's aging and disability resource center. As added by P.L.167…

Sec. 1. As used in this chapter, "program" refers to the pathways for aging risk based managed care program established under IC 12-15-13-1.8 for a covered population. As added by P.L.174-2025, SEC.41.

Sec. 2. (a) The office of the secretary shall determine the base reimbursement rate structure, methodology, and reimbursement rates that may be paid to a provider for the services rendered under the program. (b) A managed care organization may not pay a provider less than the rei…

Sec. 3. (a) A managed care organization shall contract with any nursing facility that is: (1) licensed under IC 16-28; (2) certified by: (A) the United States Department of Health and Human Services to provide services under the Medicare program; or (B) the office of the secretar…

Sec. 4. (a) On a monthly basis, a managed care organization shall provide a report to the office of the secretary concerning the denial of claims. The report must specify denials by claim type for the previous month if the denials for the claim type total at least five percent (5…

Sec. 5. The office of the secretary may conduct a claims review of claims submitted to a managed care organization for the covered population under the program. As added by P.L.174-2025, SEC.41.

Sec. 6. The office of the secretary shall at least annually conduct external reviews of claim denials in the program by a managed care organization. As added by P.L.174-2025, SEC.41.

Sec. 7. (a) This section applies to claims submitted for payment under the program by a nursing facility participating in the program. (b) The managed care organization shall pay, deny, or suspend each claim submitted by a nursing facility provider for payment under the program n…

Sec. 1. As used in this chapter, "office" refers to the office of the secretary of family and social services. As added by P.L.134-2019, SEC.2.

Sec. 2. (a) The office and a managed care organization that has contracted with the office under this article shall perform a recovery audit to ensure the integrity of the Medicaid program. (b) The office shall contract with a recovery auditing entity to perform the recovery audi…